Provider Demographics
NPI:1487090494
Name:CHANGIZI, ARASH ARI (DPM)
Entity type:Individual
Prefix:
First Name:ARASH
Middle Name:ARI
Last Name:CHANGIZI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 N GEORGE MASON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3608
Mailing Address - Country:US
Mailing Address - Phone:703-431-9976
Mailing Address - Fax:202-362-3330
Practice Address - Street 1:6130 OXON HILL RD STE 305
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3168
Practice Address - Country:US
Practice Address - Phone:301-567-5005
Practice Address - Fax:301-839-5677
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301174213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01608OtherMARYLAND LICENSE